Looking from Canada to the United States, across Niagara's Horseshoe Falls

Sunday, April 13, 2008

Liberals say fired nurses not necessarily real people

Mike Adler wrote in “Centenary cuts to be made over three years”, (Scarborough Mirror, Mar.25, 2008):

“Directors of Rouge Valley Health System say the hospital must swallow some unpleasant medicine to balance its budget and run itself more efficiently.
The 3,000 staff at Centenary Health Centre in Scarborough and the Ajax and Pickering Health Centre will be told at meetings Wednesday the hospital must cut 220 positions, including 13 managers, over the next three years.
Centenary will lose some of its 295 adult beds - 36 between surgery, cardiology and complex continuing care alone - but will gain a medical psychiatry unit by next year, giving the Nielson Road campus a new total of 274 beds.
Cuts were a foregone conclusion after the debt-ridden hospital accepted a report in December by a peer review team critical of Rouge Valley's inefficiency and years of deficit spending.
The hospital must start getting rid of its $40-million operating debt and $38-million capital debt, so a recovery plan eliminating some positions and beds is necessary for future growth, President and CEO Rik Ganderton said this week.
"We're at the point where we're out of options."
In a candid session with reporters on Monday, Ganderton and board chairperson Tom Atkins said the plan calls for the hospital to balance its budget by the final quarter of the fiscal year and to run a surplus thereafter.
"We've paved the road to financial hell with good intentions," Ganderton said. "Maybe we should have acted sooner but we've grown up a ton in the last two years."
Voluntary exit or early retirement packages should reduce the number of involuntary layoffs to "very few," he said, while the opening of Centenary's new birthing centre later this year and an Ajax-Pickering expansion scheduled for 2010 will likely provide chances for re-employment.
Changes at Rouge Valley began 18 months ago, he said, when Ganderton was made interim CEO (he was permanently in the position by last fall).
Senior hospital managers were replaced with "pretty well a new team" and the hospital stopped using agencies to hire nurses at a premium, rebuilding its pool of part-time and casual nursing staff, Ganderton said.
Now, while serving the same number of patients, Rouge Valley will reduce staff-to-patient ratios as well as the length of stay for some patients. "Keeping people in hospital longer isn't necessarily a good thing," Ganderton said.
The hospital is facing the fact it is a "poor performer" on efficiency and the province rewards efficient hospitals while doling out less cash to the less-efficient ones, Atkins said.
A board member for four and a half years, Atkins added there's some truth to criticism the board had avoided tough decisions. Members were typically told the hospital was slipping behind in its budgeting but that "we would catch up. It never happened and then you push reset," he said.
The capital funding deficit has become a handicap of its own, leaving no money free for new equipment. Centenary's boilers are 40 years old, 15 years beyond their expected lifespan and only one of four is currently working, Atkins said.
The board also sent members for training with the Ontario Hospital Association and has hired an internal auditor who is soon to deliver a separate report, Atkins said, adding a new whistleblower program will be in place at Rouge Valley in 30 to 60 days.
The 20 mental health beds in Ajax will consolidated at Centenary in a 15-bed psychiatric unit, a recommendation Ganderton said was made before the recovery plan. (There will still be two beds at each site for emergency observation).
In a statement, Psychiatry Chief Dr. Steve Fishman acknowledged "some inconvenience for families who have to travel to visit in-patients, but since fewer and fewer mental health patients tend to be hospitalized this impact should be minimal."
The hospital board approved the plan at Ajax in a Tuesday morning meeting Atkins described as uneventful. The Central East Local Health Integration Network will review the measures on Friday.”

“Mrs. Elizabeth Witmer: My question is for the Premier. Despite your rhetoric, about two thirds of the people surveyed in a year-end poll indicated they'd seen no improvement in health care. Now we learn in the Toronto Star today that 72 registered nurses are going to be fired from the Rouge Valley Health System because they can't balance their budget. This is not an isolated incident. Other hospitals are also going to be laying off staff and cutting services and beds. Premier, how can you justify the firing of these nurses?

Hon. Dalton McGuinty: To the Minister of Health.

Hon. George Smitherman: While the question remains unanswered from the earlier answers provided by our Premier, which is, where is that party's specific plan in terms of how they intend to cut $3 billion in health care-
Interjections.

Hon. George Smitherman: Obviously, asking them to come forward with a list of the $3-billion cut to health care in detail would be helpful.
In the very specific case of the Rouge Valley Health System, I can confirm that this is a hospital that has been operating beyond its level of budget. The implication, according to Rik Ganderton, the CEO, is that there may be some disruption in employment. The key thing to make note of is that it is not necessarily real people who will leave the organization. The 72-number figure-
Interjections.

Hon. George Smitherman: I know this is hard for the honourable members but-
Interjections.

The Speaker (Hon. Steve Peters): Would the member for Renfrew please take his proper seat? Thank you. Member for Kitchener-Waterloo.

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Mrs. Elizabeth Witmer: Premier, you now have the longest serving health minister in the province of Ontario. Regrettably, under his watch, we now have 66% plus of the people in the province indicating in the Nanos poll that they had seen no improvement in health care. We now have a situation where this government has refused to keep their promise to hire 8,000 new nurses in their first term. In fact, you fired 757 in January 2005.
Yesterday, Premier, you said you were not going to fire nurses. Today we learn that you are. How can you justify firing nurses for a second time?

Hon. George Smitherman: The honourable member stands in her place and is not prepared to acknowledge her record and her reputation. When they were in office, nurses were referred to as hula hoops and thousands of nurses were fired. Our record, to the contrary, as evidenced by all the data from the College of Nurses of Ontario, is that there are thousands more nurses employed in Ontario today.
On the issue of support, look to the agreement ratified recently between the Ontario Nurses' Association and the Ontario Hospital Association: the highest percentage ratification for a contract in the history of negotiations between those two parties. In the member's very own community, as a result of our intervention at the Grand River Hospital, 20 additional doctors are on site and wait times have been reduced in emergency rooms-

Mrs. Elizabeth Witmer: We hired 12,000 more nurses. We introduced family health teams.
We have a minister today who has cut hospital beds. We have fewer beds today than we did when our government was in office. We have a minister-the facts are right here, Mr. Smitherman-who said on March 31 that Ontarians don't want to lay off nurses. Today he said to the media that it "may be a necessary evil" to balance hospital budgets.
I say to you, Mr. Smitherman, how can you justify the firing of nurses?

Hon. George Smitherman: In the particular instance of one hospital in Ontario, the Rouge Valley Health System, they have been operating beyond the level of their approved budget. Accordingly, consistent with the notion that we are all accountable and responsible to work within an approved volume, they are taking the action necessary to align their budget, as all hospitals in the province are expected to.
On the issue of nursing, we are very proud to be the government that is further evolving the role of nurses, that we have a nurse-practitioner-led clinic in Sudbury and that over the course of the next several years, we will be bringing this extraordinary innovation where nurse practitioners can work together and enhance access to family health care right at the community level. Nurses are appreciated, for once, in the province-

The Speaker (Hon. Steve Peters): Thank you. New question.

Mr. Howard Hampton: A question to the Premier: Does the Premier agree with his health minister that laying off 72 nurses at Rouge Valley Health System is necessary?

Hon. Dalton McGuinty: I think we just heard, and will hear shortly again, from the Minister of Health on this score. I think that any objective assessment would help Ontarians come to the conclusion that we have hired thousands more nurses. We're proud of the fact that they're available and working in a number of different environments.
We're hiring thousands more and, as the Minister of Health just said, we're going to take this a step further. There's going to be a new evolution in the role nurses play in Ontario. We're going to have-what do we call them?-n urse-practitioner-led clinics. That's something that has been sought for a long time on the part of nurses. We think it's time to take that step forward. We have one already in Sault Ste. Marie. We look forward to putting a few dozen more around the province.

Mr. Howard Hampton: Premier, the College of Nurses of Ontario says that you failed to keep the promise that you made in 2003 to hire 8,000 new nurses. You fell more than 2,000 nurses short on that. The heart of the matter is this: Nurses are the very people in the health care system who make our hospitals work. If people are going to get quality care, we have to have nurses providing that care. Premier, why are you, who promised to hire more nurses, now in effect cutting patient care by firing nurses?

Hon. Dalton McGuinty: To the Minister of Health.

Hon. George Smitherman: It's important to note again that the 72 is a reference to positions, and this does not result in a named individual leaving a hospital corporation. This is the quote from Rik Ganderton.
I think it's important to restate the facts here: Rouge Valley Health System has seen an increase of nearly $30 million in their base budget since our government came to office. This is a substantial investment. Every hospital in Ontario has received more money, each and every year. The honourable member can make no such claims for when he was in government, nor can this party opposite. We have a hospital, Rouge Valley, that has spent beyond their approved budget. They're taking the steps necessary, which is fair not only to the local citizens but to all the citizens across the province of Ontario.
Some 17.55 million additional hours of nursing care is what's in our party's platform as we seek to further enhance the number of nurses working in Ontario, something that neither of these parties did when they were the government.

Mr. Howard Hampton: The Premier and the minister can repeat the promises all they wish. The fact of the matter is, 8,000 new nurses were not hired. The fact of the matter is, in an area where the population is growing, where patient load is growing, where health care needs are growing, the McGuinty government is now laying off nurses.
But it's not just there. A community-based bachelor of nursing program run out of Lakehead University in northwestern Ontario is also shutting down. Twenty-five annual graduates who are supposed to serve underserviced communities have been told that their program is not going to operate.
I ask the Premier again, why are the McGuinty Liberals laying off nurses in the greater Toronto area and shutting down nursing programs in northwestern Ontario when you promised to hire more nurses, because, to quote the Premier, they're the heart of the hospital and health care system?

Hon. George Smitherman: On the issue of Lakehead, it's astonishing that a member from northwestern Ontario would be so ill-informed as to offer that information. He knows it was the absence of a post-secondary institution to support that program which has allowed it to continue. There has not been any alteration whatsoever in the resources available from our government, and the honourable member knows that very well.
He knows another thing very well. He knows that nurses are the heart and soul of health care, and he knows, through a variety of initiatives, that we've done more to enhance their standing and position than any government in a good, long time.
Some 17.55 million annual hours of care are what we will add to the extraordinary progress that we've made to date, including the implementation of the new graduate guarantee that saw 86% of program participants transitioned to full-time employment.
When they were in office, we trained nurses and then we squandered them; our government's putting them to use. And nurses in Ontario ratified, to the highest degree in their history, the recent contract between the Ontario Nurses' Association and the Ontario Hospital Association. How about-

The Speaker (Hon. Steve Peters): Thank you. New question.”

*

Unflicking believable, these Liberals. Hey, Smitty: Adler wrote that Rik Ganderton also said this week: "We're at the point where we're out of options."

Why didn’t George “free-for-all” Smitherman use that little quote from the hospital chief? And who is imposing these no-option deadlines – in a monopoly setting which also denies patients any other legal alternatives to obtain alternate health-care in Ontario, other than what George and his gang magnanimously deem fit to give?

It is ominous how this demagogic Liberal Health Minister casually explains his single-payer, government-run, universal health-care system's rationing rationale; it would make Michael Moore cringe.

Smitherman says: “they have been operating beyond the level of their approved budget. Accordingly, consistent with the notion that we are all accountable and responsible to work within an approved volume, they are taking the action necessary to align their budget, as all hospitals in the province are expected to.”

In light of this Smitherman Principle, maybe Liberal MPP Jim Bradley can now explain the high death rate in his St. Catharines hospital – is that what has been happening here?

Mortality rate = alignment?

So, make sure, folks, that you get sick before your hospital’s approved budget goes out of alignment.

And if you’re unlucky enough to get sick after the approved Liberal quota has been reached – well, Smitherman has now put you on notice – don't expect to be bailed out – not in the “People’s System”, and not if George is in charge.